Biomedical subjects

Andres Pinto

Publications and source records attributed to Andres Pinto.

16 recordsLinked to original sources

PubMed2006

Management of a young patient with combined autoimmunity: Evans syndrome: a case report.

Management of patients with autoimmune disease can present a challenge for clinicians. Combinations of autoimmune disorders carry a worse prognosis and are often difficult to diagnose. Evans syndrome is a rare hematologic disorder characterized by the concurrent presentation of autoimmune hemolytic anemia and immune thrombocytopenic purpura. This paper reports the first case of the dental management of a young patient with Evans, discusses the current literature surrounding the differential diagnosis and treatment of Evans syndrome, and suggests a guide for the oral medicine, pediatric dentist, or hospital dental clinician when treating these patients.

Adolescent↗

PubMed2006

The PFAPA syndrome in oral medicine: differential diagnosis and treatment.

Periodic fever syndromes in children can present with orofacial manifestations which contribute to the formulation of a differential diagnosis. Because of the early onset of oral lesions in these syndromes, the oral medicine practitioner may be required to assist in their diagnosis and management. The periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome has been classified as a type of periodic fever syndrome ocurring in early childhood. This article presents a review of the published literature on this entity and summarizes current therapeutic options.

Analgesics↗

PubMed2006

Hypertension in children: an overview.

Hypertension in children is an increasing concern for health care professionals. Updated guidelines for the treatment of hypertension in children and adolescents were published in 2004. This report reviews the epidemiology and management of pediatric hypertension and suggests an oral health protocol to apply to hypertensive children in the dental setting. A web search was performed using Medline, PubMed, ISI Citation Index, and Cochrane evidence-based databases for articles regarding hypertension in children published in English between 1998 and 2004. Relevant articles describing the epidemiology, classification, pathophysiology, and management of pediatric hypertension are discussed, and recommendations for dental treatment of pediatric patients are suggested. The incidence of pediatric hypertension can reach 5 percent. Data on the prevalence of pediatric hypertension in the dental setting is scarce. However, using the prevalence in the general population, at least fifty young patients will be hypertensive in a busy general or pediatric practice. Dental students and residents should have the opportunity to screen for hypertension during their training and familiarize themselves with the appropriate techniques in children. Oral health professionals should become aware of the implications of hypertension in children.

Adolescent↗

PubMed2005

Pediatric soft tissue lesions.

Soft tissue oral and perioral lesions in the pediatric population are numerous and occur in various clinical presentations. Some conditions observed in children share characteristics with adult-onset disease. Other oral lesions are limited to the pediatric population. This article focuses on the more common soft tissue manifestations in children. Rather than a comprehensive review of pediatric oral pathology, the article offers an overview of selected clinical conditions often encountered in young patients.

Bacterial Infections↗

PubMed2004

Tuberculosis: medical management update.

Tuberculosis (TB) is an infectious chronic disease. After decades of steadily declining prevalence, the disease has reemerged in the last 5 years. Symptoms of TB are mild and not specific and can be classified as either systemic or localized to target organs. Microscopic examination of the sputum remains an inexpensive and rapid way to identify highly infectious patients. Four different antimicrobial agents-rifampin, ethambutol, pirazinamide, and isoniazid-form the basis of currently recommended antituberculosis therapy. Tuberculosis could be an occupational risk for health care workers. Dentists must be involved in the health promotion and early detection of TB.

Adult↗

PubMed2003

Etiology and Management of Recurrent Aphthous Stomatitis.

Recurrent aphthous stomatitis (RAS) is an ulcerative condition that affects the oral mucosa without evidence of an underlying medical disorder. RAS is characterized by the appearance of round, shallow ulcerations surrounded by inflammation that chiefly involves the nonkeratinized mucosa. The etiology of RAS is unknown, but has a strong hereditary component and appears to be related to an immune reaction against the oral mucosa. RAS must be distinguished from other diseases that cause recurring oral ulcers such as Behçet's syndrome, systemic lupus erythematosus, and Crohn's disease. This paper reviews the current theories regarding the etiology of RAS, the clinical evaluation of patients with recurring aphthous ulcers, and describes current treatment options for this condition.

Journal Article↗

PubMed2003

Epithelioid blue nevus of the oral mucosa: a rare histologic variant.

Epithelioid blue nevus (EBN) is an extremely rare histologic variant of blue nevus that has only recently been identified. Unlike other variants of blue nevus, which primarily are composed of pigmented, spindle-shaped melanocytes, EBN is characterized by large, well-defined, heavily-pigmented polygonal or epithelioid-shaped melanocytes intermixed with less densely pigmented epithelioid- and fusiform-shaped melanocytes. Furthermore, in contrast to other benign melanocytic proliferations, the lesional cells in EBN exhibit little or no maturation as they extend deeper into the underlying tissue. Blue nevi are the second most common form of nevus in the oral cavity. However, to our knowledge, the epithelioid variant has not been previously identified in the mouth. Only 6 examples of EBN have been identified in the skin of the head and neck. We now report the first documented case of EBN involving the oral mucosa. A brief review of the clinical and histopathologic features of EBN is also presented.

Humans↗

PubMed2003

Extensive pneumatization of the temporal bone and articular eminence: an incidental finding in a patient with facial pain. Case report and review of literature.

A 53-year-old Caucasian female presented to the Oral Medicine Department at the hospital of the University of Pennsylvania for consultation regarding facial pain. A panoramic radiograph revealed multilocular radiolucencies in the right articular eminence. A CT scan was then performed, and the radiolucencies were determined to be pneumatization of the articular eminence.

Air↗

PubMed2003

Burning mouth syndrome. A retrospective analysis of clinical characteristics and treatment outcomes.

Burning mouth syndrome is a condition characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the mucosa or a detectable underlying medical disorder. It is a multifactorial disorder with unclear etiology, affecting predominatly middle-aged women. Multiple approaches to treatment have been described in the literature, with few controlled clinical trials regarding their efficacy. The objectives of this retrospective study were to: 1. determine the epidemiologic characteristics of BMS patients referred to an oral medicine practice; 2. determine if BMS classification correlates with response to treatment; 3. determine the efficacy of a variety of known therapies for BMS. A database was constructed from the charts of 150 consecutive patients diagnosed with BMS; and these charts were reviewed. Patients were classified according to previously published criteria for BMS. Presumed etiologies were grouped into depression/anxiety-associated; hematinic deficiencies, including iron, folate and vitamin B complex; oral habits: and idiopathic BMS. Treatment approaches were divided into seven categories: soft desensitizing appliance; tricyclic antidepressants (TCA); benzodiazepines (BZD); topical analgesics; hematinic supplements; habit awareness counseling; and multi-modal therapy (combining two or more of the above). Improvement was recorded using a zero to 100% VAS scale and classified as no relief (0%); mild (0-40%); meaningful/moderate (41-80%); and profound relief (81-100%). Burning mouth syndrome without any identifiable cause (idiopathic) was diagnosed in 33 patients (46.6%). Patients were followed up at one month (4 weeks) after the initial visit. Nine patients (12.7%) reported profound relief; 17 patients (23.9%) reported meaningful relief; 39 patients (54.9%) reported mild relief. This retrospective review showed no significant correlation between classification of BMS and response to therapy. The most effective treatment modalities were habit awareness, followed by TCAs.

Adult↗

PubMed2002

Management of patients with thyroid disease: oral health considerations.

BACKGROUND: The thyroid gland and its hormones play an important role in the regulation of growth, development and metabolic functions of the body. Thyroid diseases include a group of conditions that can affect the delivery of dental care. LITERATURE REVIEWED: The authors conducted a MEDLINE search of the medical and dental literature concerning thyroid disease and its management published between 1980 and 2000. The authors found eight published articles concerning this topic in the dental literature; a few of the articles specifically addressed thyroid disease and dental care. They reviewed the medical literature within the scope of provision of dental care. CONCLUSIONS: The oral health care professional can play a role in the screening of dental patients who have undiagnosed thyroid disease. In addition, to treat patients who have thyroid disease, a thorough understanding of the many related pathological conditions, as well as the signs and symptoms that can occur, is needed. Specific dental treatment protocols for these patients are not found in the medicodental literature published between 1980 and 2000. CLINICAL IMPLICATIONS: As part of a health care team, the dentist plays an important role in detecting thyroid abnormalities. Modifications of dental care must be considered when treating patients who have thyroid disease.

Adrenergic Antagonists↗

PubMedDate not supplied

Granulocytic sarcoma: an atypical presentation in the oral cavity.

Acute myelogenous leukemia (AML) is a hematologic disorder that is characterized by an abnormal proliferation of immature myeloid cells. Granulocytic sarcomas are clusters of leukemic myeloid cells that may develop as a result of AML. Oral manifestations of AML are common and often involve enlargements of the gingiva and/or mucosal tissue from direct leukemia cell infiltration. We describe the case history of a 50-year-old man who had an ulcerative lesion of the oral mucosa that was determined to be a granulocytic sarcoma of AML-MO subtype. The combination of both the subtype and clinical presentation of the leukemia makes this presentation unusual, and to the best of our knowledge, of a type that has not been previously reported in the literature.

Diagnosis, Differential↗

PubMedDate not supplied

Pemphigus: update for the general practitioner.

Pemphigus is a dermatologic disease that can affect both the skin and mucous membranes. Pemphigus affects the oral cavity; the most common form of the disease that is observed clinically is pemphigus vulgaris. Oral lesions may precede skin lesions; therefore, it is imperative that clinicians are aware of the clinical signs and symptoms of this disorder. This article will review the etiology, symptomatology, diagnostic tools, and treatments available to diagnose and manage this disease.

Glucocorticoids↗

PubMedDate not supplied

Burning mouth syndrome: a guide for the general practitioner.

A commonly misdiagnosed condition, burning mouth syndrome (BMS) is characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the oral mucosa. BMS affects middle-aged women predominantly. This condition has a multifactorial etiology, although several conditions have been associated with BMS, including depression/anxiety, hematinic deficiencies (iron, folate, and vitamin B complex), oral habits such as tongue thrusting and bruxism, and idiopathic BMS. Multiple approaches to treatment have been described in the literature, although few controlled clinical trials have been designed to determine their efficacy. This article examines BMS, its related factors, and treatment options available to the general dentist.

Burning Mouth Syndrome↗

PubMedDate not supplied

Herpes simplex and varicella-zoster infections: clinical and laboratory diagnosis.

One of a dentist's most common diagnostic challenges is determining the cause of vesiculo-ulcerative disorders of the oral cavity. The most common etiology of oral vesicles is herpes simplex virus (HSV) infection. Varicella-zoster virus (VZV) is a less common etiology of vesicles in the oral cavity. Dentists often are able to differentiate these two viruses based on the clinical presentation of infectious symptoms; however, further laboratory testing is required to identify herpetically induced vesiculo-ulcerative lesions definitively. This article reviews the basic clinical signs and symptoms of HSV and VZV infection and describes the various laboratory tests that can determine the definitive etiology of the vesiculo-ulcerative disorder.

Cytodiagnosis↗

PubMedDate not supplied

Salivary gland disease in pediatric HIV patients: an update.

Oral manifestations are one of the earliest clinical indicators of HIV infection and progression in children. Prompt recognition of these signs and symptoms by dental providers can help in the diagnosis and intervention of delaying the progression of HIV disease to AIDS. Salivary gland disease is a common manifestation of HIV infection in pediatric patients, presenting either as gland enlargement and/or xerostomia. The parotid glands by far are most frequently affected, though the other major glands are commonly involved. Diseases of the salivary glands and the corresponding quantitative changes in saliva affect the homeostasis of the oral cavity and account for significant morbidity during the progression of HIV disease. This paper summarizes the research on HIV-related salivary gland disease and outlines treatment and management considerations.

Anti-Bacterial Agents↗

PubMedDate not supplied

Systemic conditions associated with periodontitis in childhood and adolescence. A review of diagnostic possibilities.

The term periodontitis is used to describe a group of multifactorial diseases that result in the progressive destruction of the structures that support the teeth within the jaws, the so-called attachment apparatus, which includes the periodontal ligament, cementum and alveolar bone. If left untreated, this process can ultimately lead to tooth loss. The pathogenesis of these diseases involves the initial colonization of the gingival microenvironment of a susceptible host by pathogenic bacteria found in dental plaque. Subsequently, much of the tissue destruction characteristic of periodontitis is a , by-product, of the host response directed against these organisms. One of the major factors that appear to modulate disease severity is systemic health. Severe periodontitis in young individuals can therefore be a manifestation of an underlying systemic disease. In this review we will discuss the most important systemic diseases that should be considered in a differential diagnosis when evaluating a pediatric patient presenting with periodontitis.

Adolescent↗